Posted by medik-ukm on Friday, October 22, 2010
QuestionWhy you cannot give dextrose to hyperemesis gravidarum patient?AnswerDextrose containing solutions should be avoided as they increase the body’s requirements for thiamine and thus increase the chance of precipitating Wernicke encephalopathy in a woman who is already thiamine deficientthanks to Izzati Rani===============================additional information from wong yee mingDextrose infusion can always be considered if the patient is too hypoglycemic and could not tolerate orally. All we need is to supplement them with thiamine (IV thiamine can be given), preferably before dextrose infusion, although it's just to appease the myth that thiamine should be given before dextrose infusion. It's all based on clinical judgment, and no clear cut answ...
Posted by medik-ukm on Tuesday, October 19, 2010
[5 x (height in centimetre)] - 400however, in exam, please mentioned that you will compare the result with PEF chart.thanks to ha...
Posted by medik-ukm on Monday, October 18, 2010
|||suggested steps for informed consent for colonoscopy|||ONEIntroduce; build rapport; greetTWOExplain what the patient have; possible diagnosis, based on the trigger givenTHREEExplain what is colonoscopyFOURIndication for colonoscopyPR Bleedunexplained alter bowel habitfamily history of cancerIBDFIVEProcedure of colonoscopyBowel prep (explain how to bowel prep)Register on the datechange clothEnemaLA / GA bring partner to ensure safety after the procedure because patient may still be in sedative state Position left lateralInsert per rectalInsert air may cause abdominal discomfort, flatulenceInsert cameraBiopsy may be taken depending on findingsSIXPossible findings during colonoscopybleedingmassulcerinflammationSEVENComplication of colonoscopyBleedingPerforationPainEIGHTBenefitDiagnosticTherapeuticNINELet...
Posted by medik-ukm on Monday, October 18, 2010
Describe the salient features. (5 marks)Increased radiolucency right hemithoraxTrachea shifted to the leftLoss of vascular markingsMediastinal shiftCollapsed right lung What is the diagnosis. (3 marks)Right Tension PneumothoraxWhat is the immediate treatment? (2marks)Needle thoracocentesis at right 2nd ICS midclavicular line ...
Posted by medik-ukm on Saturday, October 16, 2010
MOCK OSCE SURGERYDemonstrate the method of male catheter bladderSUGGESTION ANSWERIntroduce and greetExplain to patient and obtain consentEnsure privacyASEPTIC TECHNIQUE!Prepare equipmentsWash hand and wear sterile glove.Clean and drapeSquirt local anaesthetic gel into urethraHold penis upward positionInsert catheter gentlyCheck the drainage of urine; press bladder if no urine drainedInflate balloon with amount of water (not normal saline!!! why not normal saline?) as stated on the catheterPull back catheter until resistance encounteredConnect catheter to urine bag...
Posted by medik-ukm on Saturday, October 16, 2010
EXAMPLE OSCE SURGERY A 68 years old female is admitted to the ward.Clinically she is dehydrated and requires intravenous hydration.You are the house officer in charge.Please demonstrate the insertion of peripheral venous cannula.||||||||||||||||||||||||||||||||||SUGGESTION ANSWER Introduce and greetExplain to patient and obtain oral consentSelect appropriate site (where?)Apply tourniquetClean with alcohol swabVenepuncture made comfirmed by ‘flashback’Advanced the cannula 2-3 mm into veinSheath advance into vein and needle withdrawnTourniquet releasedCannula secured with adhesive tapeFlush with saline prior to use to ensure cannula is in-situ...
Posted by medik-ukm on Saturday, October 16, 2010
Medical students MUST know how to instruct patient on the technique of using Peak Expiratory Flow.I dont know whether it can come out in exam, but i'm sure you will have to instruct the patient some other day, maybe when you become a houseman.Sorry if there are any mistakes in the information below.ONEYour mouth must be empty.For best results, you should stand.If you are unable to stand, sit-up straight.TWOSet the peak flow meter to zero at the bottom of the meter.THREEHold in your hand with your thumb and forefinger on the grips and the mouthpiece facing toward you.Younger children may opt to hold the device with both thumbs underneath and fingers on the grips.Avoid blocking the vent holes as much as possible and do not allow fingers to interfere with the Peak Indicator.FOURTake as deep a...
Posted by medik-ukm on Saturday, October 16, 2010
source : Diarrhea Case Report Form, Hospital Slim River.||||||||||||||||||||||||||||||||||||||||||||||bonus information :World Gastroenterology Organisation Practice Guideline of Acute Diarrhea Mac 2...
Posted by medik-ukm on Thursday, October 14, 2010
Abdominal Pain or TendernessPersistent VomitingClinical Fluid Accumulation (pleural effusion/ascites)Mucosal BleedRestlessness or LethargyTender Enlarged LiverIncrease in HCT concurrent with rapid decrease in plate...
Posted by medik-ukm on Monday, October 11, 2010
Stage 1slight reticular (slight granular) decrease in transparency of the lung, no certain difference to normal findings.Stage 2Soft decrease in transparency with an aerobronchogram, which overlaps the heart (= always a sign of an alveolar lung reaction!)Stage 3like stage 2, but with gradual stronger decrease in transparency, as well as a blurry diaphragm and heart.Stage 4White lung: practically homogenic lung opacitySynopsis of the changes in Stages I - IV.source : http://www.kinderradiologie-online.de/radiology/20021110223558.shtml...
Posted by medik-ukm on Monday, October 11, 2010
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Posted by medik-ukm on Monday, October 11, 2010
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Posted by medik-ukm on Monday, October 11, 2010
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